Interventional neuropediatrics: treatment of dystonic and spastic muscular hyperactivity with botulinum toxin A.
Therapeutic effect of botulinum toxin A was studied in a group of pediatric patients (n = 28) aged between 6 months and 18 years. The patients were diagnosed with cervical dystonia (n = 6), adductor spasm of the hip (n = 8), spastic drop foot (n = 7) and various other focal motor problems associated with spastic muscular hyperactivity (n = 7). The mean dose of botulinum toxin A (Dysport) used to inject into the affected muscle was 22 U/kg body weight. Reduced muscular hyperactivity with a significant increase in joint mobility was achieved for dystonic (p < 0.0001) as well as for spastic conditions in patients with adductor spasm (p < 0.0002). For these patients the improved joint mobility represented a significant benefit for both daily activities and nursing care. Local paresis and local hematoma were observed in 1/28 and 1/28 patients, respectively; 1/28 patients developed a secondary non-response. However, apart from these side effects, no other adverse reactions to botulinum toxin A treatment were recorded during the treatment and observation period (12-64 months). Our results suggest that botulinum toxin A represents an effective and safe therapeutic substance for the treatment of pediatric patients suffering of focal motor problems due to dystonic or spastic muscular hyperactivity.
Heinen
F
F
Department of Neuropediatrics, University Hospital Freiburg, Germany.
Wissel
J
J
Philipsen
A
A
Mall
V
V
Leititis
J U
JU
Schenkel
A
A
Stücker
R
R
Korinthenberg
R
R
D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004421:Dystonia / Q000175:diagnosis / Q000188:drug therapy*; D004576:Electromyography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009128:Muscle Spasticity / Q000175:diagnosis / Q000188:drug therapy*; D018482:Muscle, Skeletal / Q000294:innervation; D009462:Neurology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010372:Pediatrics; D012720:Severity of Illness Index
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A